Provider Demographics
NPI:1841581519
Name:WILLEFORD, ASHLEY NICOLE (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:WILLEFORD
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:405-341-1557
Mailing Address - Fax:405-341-5615
Practice Address - Street 1:105 S. BRYANT AVE
Practice Address - Street 2:#304
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6331
Practice Address - Country:US
Practice Address - Phone:405-341-1557
Practice Address - Fax:405-341-5615
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2012-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK87967363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200328580AMedicaid
OK200328580AMedicaid